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Endo K, Tanaka M, Sato T, Mori K, Hosaka I, Mikami T, Umetsu A, Akiyama Y, Ohnishi H, Hanawa N, Furuhashi M. A high level of thyroid-stimulating hormone is a risk factor for the development of chronic kidney disease in men: a 10-year cohort study. Hypertens Res 2024; 47:663-671. [PMID: 37845396 DOI: 10.1038/s41440-023-01453-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/27/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023]
Abstract
Hypothyroidism has been reported to be associated with chronic kidney disease (CKD). However, the impact of thyroid-stimulating hormone (TSH) on new onset of CKD and its gender dependence remain undetermined. We investigated the association of serum TSH level and the development of CKD defined by estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or positive for urine protein in 28,990 Japanese subjects who received annual health examinations. After excluding subjects with no data for serum TSH, urinalysis and eGFR and those with CKD at baseline, a total of 10,392 subjects (men/women: 6802/3590, mean age: 48 years) were recruited. During a 10-year follow-up, 1185 men (6.7%) and 578 women (2.9%) newly developed CKD. Multivariable Cox proportional hazard models after adjustment of age, body mass index, smoking habit, hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease and eGFR (≥ 90 mL/min/1.73 m2) showed that the hazard ratio (HR) for the development of CKD in the high TSH (> 4.2 mU/L) group was significantly higher than that in the low TSH (≤ 4.2 mU/L) group in men (HR [95% confidence interval]: 1.41 [1.09-1.83]) but not in women (1.08 [0.77-1.51]). There was a significant interaction between sex and the category of TSH level for the development of CKD (p = 0.02). The adjusted HR with a restricted cubic spline increased with a higher level of TSH in men but not in women. In conclusion, a high level of TSH is associated with an increased risk for the development of CKD in men but not in women.
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Affiliation(s)
- Keisuke Endo
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Tanaka Medical Clinic, Yoichi, Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kazuma Mori
- Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takuma Mikami
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Araya Umetsu
- Department of Ophthalmology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Yukinori Akiyama
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nagisa Hanawa
- Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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Yu W, Wang Y, Ma L, Gou S, Fu P. Analysis of Thyroid Function in ANCA-Associated Vasculitis Patients with Renal Injury. J Pers Med 2024; 14:99. [PMID: 38248799 PMCID: PMC10817250 DOI: 10.3390/jpm14010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Previous studies indicated common thyroid dysfunction in various kidney diseases. This study aimed to investigate the thyroid function in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) with renal injury. METHODS Briefly, 174 patients diagnosed as having AAV with renal injury and without previous thyroid disease history were included in the retrospective and prospective study. The clinical parameters were collected and compared between different groups. RESULTS Of the patients included, 24 exhibited normal thyroid function, while 150 had thyroid dysfunction, including 55 (36.67%) with hypothyroidism. Those AAV patients with thyroid dysfunction showed different clinical parameters from those with normal thyroid function. The patients were followed up for a median of 68.6 (64.3; 72.8) months. Those with thyroid dysfunction were more prone to progressing to dialysis dependence compared to the group with normal thyroid function. Logistic regression analysis showed advanced age and decreased albumin as independent risk factors for thyroid dysfunction in patients with AAV. Survival analysis and multivariate Cox regression analysis showed that thyroid dysfunction was a risk factor for AAV patients with renal injury to progress to the endpoint of dialysis dependence. CONCLUSION Thyroid dysfunction, predominantly hypothyroidism, was commonly complicated in AAV patients with renal injury. AAV patients with thyroid dysfunction were presented with different clinical parameters and more prone to progressing to dialysis dependence compared to those with normal thyroid function.
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Affiliation(s)
- Wenhui Yu
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China; (W.Y.); (L.M.); (P.F.)
| | - Yuelan Wang
- Renal Division, Department of Medicine, Chengdu Second People’s Hospital, Chengdu 610041, China;
| | - Liang Ma
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China; (W.Y.); (L.M.); (P.F.)
| | - Shenju Gou
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China; (W.Y.); (L.M.); (P.F.)
- Department of Nephrology, West China Tianfu Hospital of Sichuan University, Chengdu 610200, China
| | - Ping Fu
- Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China; (W.Y.); (L.M.); (P.F.)
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You AS, Kalantar-Zadeh K, Brent GA, Narasaki Y, Daza A, Sim JJ, Kovesdy CP, Nguyen DV, Rhee CM. Impact of Thyroid Status on Incident Kidney Dysfunction and Chronic Kidney Disease Progression in a Nationally Representative Cohort. Mayo Clin Proc 2024; 99:39-56. [PMID: 38176833 PMCID: PMC10795379 DOI: 10.1016/j.mayocp.2023.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 08/12/2023] [Accepted: 08/29/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE To examine the relationship between thyroid status and incident kidney dysfunction/chronic kidney disease (CKD) progression. PATIENTS AND METHODS We examined incident thyroid status, ascertained by serum thyrotropin (TSH) levels measured from January 1, 2007, through December 31, 2018, among 4,152,830 patients from the Optum Labs Data Warehouse, containing deidentified retrospective administrative claims data from a large national health insurance plan and electronic health record data from a nationwide network of provider groups. Associations of thyroid status, categorized as hypothyroidism, euthyroidism, or hyperthyroidism (TSH levels >5.0, 0.5-5.0, and <0.5 mIU/L, respectively), with the composite end point of incident kidney dysfunction in patients without baseline kidney dysfunction and CKD progression in those with baseline CKD were examined using Cox models. RESULTS Patients with hypothyroidism and hyperthyroidism had higher risk of incident kidney dysfunction/CKD progression in expanded case-mix analyses (reference: euthyroidism): adjusted hazard ratios (aHRs) (95% CIs) were 1.37 (1.34 to 1.40) and 1.42 (1.39 to 1.45), respectively. Incrementally higher TSH levels in the upper reference range and TSH ranges for subclinical, mild overt, and overt hypothyroidism (≥3.0-5.0, >5.0-10.0, >10.0-20.0, and >20.0 mIU/L, respectively) were associated with increasingly higher risk of the composite end point (reference: TSH level, 0.5 to <3.0 mIU/L): aHRs (95% CIs) were 1.10 (1.09 to 1.11), 1.37 (1.34 to 1.40), 1.70 (1.59 to 1.83), and 1.70 (1.50 to 1.93), respectively. Incrementally lower TSH levels in the subclinical (<0.5 mIU/L) and overt (<0.1 mIU/L) hyperthyroid ranges were also associated with the composite end point: aHRs (95% CIs) were 1.44 (1.41 to 1.47) and 1.48 (1.39 to 1.59), respectively. CONCLUSION In a national cohort, TSH levels in the upper reference range or higher (≥3.0 mIU/L) and below the reference range (<0.5 mIU/L) were associated with incident kidney dysfunction/CKD progression.
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Affiliation(s)
- Amy S You
- Division of Nephrology, Hypertension, and Kidney Transplantation, University of California Irvine, Orange, CA; Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology, Hypertension, and Kidney Transplantation, University of California Irvine, Orange, CA; Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA
| | - Gregory A Brent
- Division of Endocrinology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA; Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Yoko Narasaki
- Division of Nephrology, Hypertension, and Kidney Transplantation, University of California Irvine, Orange, CA; Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA
| | - Andrea Daza
- Division of Nephrology, Hypertension, and Kidney Transplantation, University of California Irvine, Orange, CA; Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA
| | - John J Sim
- Division of Nephrology and Hypertension, Kaiser Permanente Southern California, Los Angeles, CA
| | - Csaba P Kovesdy
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN; Memphis Veterans Affairs Medical Center, Memphis, TN
| | - Danh V Nguyen
- Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA; Division of General Internal Medicine, University of California Irvine, Orange, CA
| | - Connie M Rhee
- Division of Nephrology, Hypertension, and Kidney Transplantation, University of California Irvine, Orange, CA; Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA.
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Fang T, Deng X, Wang J, Han F, Liu X, Liu Y, Sun B, Chen L. The effect of hypothyroidism on the risk of diabetes and its microvascular complications: a Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1288284. [PMID: 38116309 PMCID: PMC10728873 DOI: 10.3389/fendo.2023.1288284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
Context Several observational studies have found that hypothyroidism is associated with diabetes and its microvascular complications. However, the cause and effect have not been clarified. Objective The aim of the study was to examine the causality of such associations by a Mendelian randomization study. Methods Two-sample Mendelian randomization analysis was conducted to investigate the associations. Summary statistics for hypothyroidism were from the UK Biobank, and diabetes and its microvascular complications were from the largest available genome-wide association studies. MR-Egger, weighted median, inverse variance weighted, simple mode and weighted mode were used to examine the causal associations, and several sensitivity analyses were used to assess pleiotropy. Results Inverse variance weighted estimates suggested that hypothyroidism was associated with type 1 diabetes and type 1 diabetes with renal complications (β= 9.059926, se= 1.762903, P = 2.76E-07 and β= 10.18375, se= 2.021879, P = 4.73E-07, respectively) but not type 2 diabetes and type 2 diabetes with renal complications. In addition, hypothyroidism was positively associated with severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy (β= 8.427943, se= 2.142493, P = 8.36E-05 and β= 3.100939, se= 0.74956, P=3.52E-05, respectively). Conclusions The study identified the causal roles of hypothyroidism in diabetes and its microvascular complications. Hypothyroidism can lead to type 1 diabetes, type 1 diabetes with renal complications, severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy.
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Affiliation(s)
- Ting Fang
- NHC Key Laboratory of Hormones and Development, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Xiaoqing Deng
- NHC Key Laboratory of Hormones and Development, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Jingyi Wang
- NHC Key Laboratory of Hormones and Development, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Fei Han
- NHC Key Laboratory of Hormones and Development, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Xiangyang Liu
- NHC Key Laboratory of Hormones and Development, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Yajin Liu
- NHC Key Laboratory of Hormones and Development, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Bei Sun
- NHC Key Laboratory of Hormones and Development, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Liming Chen
- NHC Key Laboratory of Hormones and Development, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
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Gontarz-Nowak K, Szklarz M, Szychlińska M, Matuszewski W, Bandurska-Stankiewicz E. A Brief Look at Hashimoto's Disease, Adrenal Incidentalomas, Obesity and Insulin Resistance-Could Endocrine Disruptors Be the Other Side of the Same Coin? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1234. [PMID: 37512046 PMCID: PMC10385892 DOI: 10.3390/medicina59071234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/20/2023] [Accepted: 06/24/2023] [Indexed: 07/30/2023]
Abstract
Hashimoto's disease (HD) is the most common cause of hypothyroidism in developed countries. The exact pathomechanism behind it has not been clearly established; however, an interplay of genetic susceptibility, environmental triggers (including diet) and epigenetic factors seems to be involved. Among the latter, increasingly more attention has been paid to some hormonally active substances, known as endocrine disruptors, which are commonly used worldwide. HD has become a condition widely reported in the media, acting as a culprit for inexplicable weight gain, chronic fatigue or weakness. Nevertheless, the recognition of HD is undeniably increasing and represents a major public health burden. At the same time, improving access to imaging tests has increased the number of incidentally diagnosed adrenal tumors. Above all, the widespread use of chest computed tomography (CT) due to the COVID-19 pandemic has contributed to frequent incidental detection of adrenal lesions. Fortunately, a vast majority of these findings are asymptomatic benign tumors with no excessive hormonal activity, and therefore, they are defined as adrenal incidentalomas (AIs). Interestingly, recent studies have indicated that patients with AIs are more prone to obesity and insulin resistance. Although mutual relationships between the thyroid and the adrenal glands have been studied widely, still, little is known about the possible pathophysiological associations between thyroid autoimmunity and the occurrence of adrenal incidentalomas. This article presents a brief review of the common endocrine disorders with a special focus on the frequently coexisting insulin resistance and/or obesity. Furthermore, in response to the recent growing interest in endocrine disruptors, with their transgenerational epigenetic effects that influence hormonal system function, a concise overview of the topic has also been included.
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Affiliation(s)
- Katarzyna Gontarz-Nowak
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Michał Szklarz
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Magdalena Szychlińska
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Wojciech Matuszewski
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Elżbieta Bandurska-Stankiewicz
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
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Kidney disease and thyroid dysfunction: the chicken or egg problem. Pediatr Nephrol 2022; 37:3031-3042. [PMID: 35737115 DOI: 10.1007/s00467-022-05640-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/04/2022] [Accepted: 05/19/2022] [Indexed: 01/10/2023]
Abstract
Patients with non-dialysis-dependant chronic kidney disease (NDD-CKD) and dialysis-dependant chronic kidney disease (DD-CKD) frequently also suffer from thyroid disorders, especially hypothyroidism which is found two to five times more often among them compared to the general population. Emerging research has illustrated the potential prognostic implications of this association as NDD-CKD and DD-CKD patients with hypothyroidism have been shown to have higher mortality rates, and treatment of subclinical hypothyroidism in NDD-CKD patients has been reported to attenuate the decline of glomerular filtration rate over time. This review illustrates the bidirectional, multi-layered interplay between the kidneys and the thyroid gland explaining how pathologies in one organ will affect the other and vice versa. Additionally, it outlines the impact of thyroid disorders on routine parameters of kidney function (especially serum creatinine and serum cystatin C) that nephrologists should be aware of in their clinical practice. Lastly, it summarizes the emerging evidence from clinical studies on how treatment of subclinical hypothyroidism in NDD-CKD and DD-CKD patients may potentially have beneficial effects on kidney function as well as mortality. While most of the research in this area has been performed on adult patients, we specifically discuss what is currently known about thyroid dysfunctions in paediatric CKD patients as well and provide management suggestions. The evidence accumulated so far clearly indicates that further, prospective studies with meticulous methodology are warranted to refine our understanding of thyroid disorders in paediatric and adult CKD patients and establish optimal treatment pathways.
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Persani L, Campi I. Variation in Thyroid Hormone Metabolism May Affect COVID-19 Outcome. J Clin Endocrinol Metab 2022; 107:e3078-e3079. [PMID: 35325144 PMCID: PMC8992329 DOI: 10.1210/clinem/dgac152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Luca Persani
- Correspondence: Luca Persani, MD, PhD, Department of Endocrine and Metabolic Diseases, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Piazzale Brescia 20, 20149 Milan, Italy.
| | - Irene Campi
- Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
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Elevated Thyroxine Concentration and Lithium Intoxication—An Analysis Based on the LiSIE Retrospective Cohort Study. J Clin Med 2022; 11:jcm11113041. [PMID: 35683429 PMCID: PMC9181082 DOI: 10.3390/jcm11113041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: It has been suggested that hyperthyroxinaemia is a risk factor for lithium intoxication by altering tubular renal function. (2) Methods: We determined the relevance of hyperthyroxinaemia as a risk factor for lithium intoxication in patients with bipolar or schizoaffective disorder in the framework of the LiSIE (Lithium-Study into Effects and Side Effects) retrospective cohort study. Of 1562 patients included in the study, 897 patients had been exposed to lithium at any time between 1997 and 2017 with 6684 person-years of observation. (3) Results: There were 65 episodes of unintentional lithium intoxication in 53 patients. There were nine episodes with hyperthyroxinaemia at the time of lithium intoxication, yielding an incidence of 1.3 episodes/1000 person-years. For all nine episodes, we could identify alternative, more plausible, explanations for the observed lithium intoxications. (4) Conclusions: We conclude that hyperthyroxinaemia-associated unintentional lithium intoxication is an uncommon event. A direct causal link between hyperthyroxinaemia and altered tubular renal function remains elusive. Increasing the frequency of routine thyroid function tests seems unlikely to decrease the risk of lithium intoxication.
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Permana H, Soeriadi EA, Damara FA, Mulyani Soetedjo NN. The prognostic values of thyroid disorders in predicting COVID-19 composite poor outcomes: A systematic review and meta-analysis. Diabetes Metab Syndr 2022; 16:102464. [PMID: 35508091 PMCID: PMC8930180 DOI: 10.1016/j.dsx.2022.102464] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/27/2022] [Accepted: 03/15/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS In this meta-analysis, we aimed to evaluate the prognostic properties of thyroid disorder during admission on poor prognosis and factors that may influence the relationship in patients with COVID-19. METHODS A systematic literature search of PubMed, EBSCO, and CENTRAL was conducted from inception to August 27, 2021. The main exposure was unspecified and specified thyroid disorders-hypothyroidism or hypothyroidism. The outcome of interest was the COVID-19 composite poor outcome that comprises of severity, mortality, ICU admission, and hospitalization. RESULTS There were 24,734 patients from 20 studies. Meta-analysis showed that thyroid disorder was associated with composite poor outcome (OR 2.87 (95% CI 2.04-4.04), p < 0.001; I2 = 62.4%, p < 0.001). Meta regression showed that age (p = 0.047) and hypertension (p = 0.01), but not gender (p = 0.15), DM (p = 0.10), CAD/CVD (p = 0.38), obesity (p = 0.84), and COPD (p = 0.07) affected the association. Subgroup analysis showed that thyroid disorder increased risk of severe COVID-19 (OR 5.13 (95% CI 3.22-8.17), p < 0.05; I2 = 0%, p = 0.70) and mortality (OR 2.78 (95%CI 1.31-5.90), p < 0.05; I2 = 80%, p < 0.01). Pooled diagnostic analysis of thyroid disorder yielded a sensitivity of 0.22 (0.13-0.35), specificity of 0.92 (0.87-0.95), and AUC of 0.72. The probability of poor outcome was 38% in patients with thyroid disorder and 15% in patients without thyroid abnormality. CONCLUSION On-admission thyroid disorder was associated with poor prognosis in COVID-19 patients.
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Affiliation(s)
- Hikmat Permana
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran - Dr Hasan Sadikin Hospital, Bandung, Indonesia
| | - Erwin Affandi Soeriadi
- Department of Nuclear Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Fachreza Aryo Damara
- Faculty of Medicine, Universitas Padjadjaran - Dr Hasan Sadikin Hospital, Bandung, Indonesia
| | - Nanny Natalia Mulyani Soetedjo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran - Dr Hasan Sadikin Hospital, Bandung, Indonesia.
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Khurana V, Goswami B. Angiotensin converting enzyme (ACE). Clin Chim Acta 2022; 524:113-122. [PMID: 34728179 DOI: 10.1016/j.cca.2021.10.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/16/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Angiotensin converting enzyme (ACE) was isolated as a 'hypertensinconverting enzyme'. There have been considerable advances in understanding the metabolic role of ACE in the body. This review attempts to highlight the role of ACE enzyme in the physiological and pathological processes occurring in the organs in which it is localized. METHODS The literature was searched from the websites of the National Library of Medicine (http://www.ncbi.nlm.nih.gov/) and Pub Med Central, the U.S. National Library of Medicine's digital archive of life sciences journal literature. RESULTS The involvement of ACE in regulation of blood pressure forms its central action but it has a role to play in a variety of physiological processes occurring in the organs in which it is localized like the lungs, macrophages, brain, pancreas, liver etc. It has also been implicated in the pathogenesis of a number of diseases including COVID-19. CONCLUSIONS More studies need to be carried out in order to validate the use of ACE levels in the diagnosis and monitoring of the diseases associated, and facilitate the use of ACE inhibitors and Angiotensin Receptor Blockers in the management of the same, so this wonder molecule can be utilized to its full potential.
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Affiliation(s)
- Vatsala Khurana
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India.
| | - Binita Goswami
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
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11
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Lang H, Wan X, Ma M, Peng H, Zhang H, Sun Q, Zhu L, Cao C. Low Triiodothyronine Syndrome Increased the Incidence of Acute Kidney Injury After Cardiac Surgery. Int J Gen Med 2022; 15:867-876. [PMID: 35115813 PMCID: PMC8800588 DOI: 10.2147/ijgm.s349993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
Background Acute kidney injury (AKI) is a severe complication of cardiac surgery. This study was designed to explore the association between the preoperative low T3 syndrome and cardiac surgery-associated acute kidney injury (CSA-AKI). Methods This was a retrospective single-center study. Data on 784 patients undergoing elective coronary artery bypass grafting (CABG) or valve surgery were collected from January 2016 to July 2019. AKI was defined according to Kidney Disease: Improving Global Outcomes guidelines. The effect of preoperative low T3 syndrome (fT3 < 3.5pmol/L) on the risk of the postoperative AKI was analyzed in a logistic regression model. Results There were 171 (21.8%) patients developing AKI. Preoperative T3 and FT3 levels were lower in patients with AKI than in those without AKI (P < 0.001). The incidence of postoperative AKI was higher in patients with low T3 syndrome than in those without (31.0% vs 19.8%; P = 0.003). Multivariate logistic regression analysis showed that low T3 syndrome was an independent risk factor for CSA-AKI patients (OR = 1.609, 95% CI: 1.033–2.504; P = 0.035), after adjusting for confounding factors, such as age, albumin, and uric acid. Subgroup analyses showed that preoperative low T3 syndrome also increased incidence of CSA-AKI in those with high risk factors, such as age ≧60 yrs (OR: 1.891, 95% CI: 1.183–3.022, P = 0.008), hypertension (OR: 2.104, 95% CI: 1.218–3.3.635, P = 0.008), and hyperuricemia (OR: 2.052, 95% CI: 1.037–4.06, P = 0.039). Conclusion Low T3 syndrome independently increases the risk of CSA-AKI. Patients with low T3 syndrome should be considered at higher risk and be evaluated before cardiac surgery.
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Affiliation(s)
- Hong Lang
- Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Xin Wan
- Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Mengqing Ma
- Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Hui Peng
- Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Hao Zhang
- Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Qing Sun
- Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Li Zhu
- Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Changchun Cao
- Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
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Uchiyama-Matsuoka N, Tsuji K, Uchida HA, Kitamura S, Itoh Y, Nishiyama Y, Morimoto E, Fujisawa S, Terasaka T, Hara T, Ogura-Ochi K, Inagaki K, Wada J. Masked CKD in hyperthyroidism and reversible CKD status in hypothyroidism. Front Endocrinol (Lausanne) 2022; 13:1048863. [PMID: 36425466 PMCID: PMC9678909 DOI: 10.3389/fendo.2022.1048863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION While it is well known that thyroid function may affect kidney function, the transition of the chronic kidney disease (CKD) status before and after treatment for thyroid disorders, as well as the factors affecting this change, remains to be explored. In the present study, we focused on the change in kidney function and their affecting factors during the treatment for both hyperthyroidism and hypothyroidism. METHODS Eighty-eight patients with hyperthyroidism and fifty-two patients with hypothyroidism were enrolled in a retrospective and longitudinal case series to analyze the changes in kidney function and their affecting factors after treatment for thyroid disorders. RESULTS Along with the improvement of thyroid function after treatment, there was a significant decrease in estimated glomerular filtration rate (eGFR) in hyperthyroidism (an average ΔeGFR of -41.1 mL/min/1.73 m2) and an increase in eGFR in hypothyroidism (an average ΔeGFR of 7.1 mL/min/1.73 m2). The multiple linear regression analysis revealed that sex, eGFR, free thyroxine (FT4) and free triiodothyronine (FT3) could be considered independent explanatory variables for ΔeGFR in hyperthyroidism, while age, eGFR, and FT3 were detected as independent explanatory variables in hypothyroidism. In addition, the stratification by kidney function at two points, pre- and post-treatment for thyroid disorders, revealed that 4.5% of the participants with hyperthyroidism were pre-defined as non-CKD and post-defined as CKD, indicating the presence of "masked" CKD in hyperthyroidism. On the other hand, 13.5% of the participants with hypothyroidism presented pre-defined CKD and post-defined non-CKD, indicating the presence of "reversible" CKD status in hypothyroidism. CONCLUSIONS We uncovered the population of masked CKD in hyperthyroidism and reversible CKD status in hypothyroidism, thereby re-emphasizing the importance of a follow-up to examine kidney function after treatment for hyperthyroidism and the routine evaluation of thyroid function in CKD patients as well as the appropriate hormone therapy if the patient has hypothyroidism.
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Affiliation(s)
- Natsumi Uchiyama-Matsuoka
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kenji Tsuji
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- *Correspondence: Kenji Tsuji,
| | - Haruhito A. Uchida
- Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Academic field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shinji Kitamura
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshihiko Itoh
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Nishiyama
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Eisaku Morimoto
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Satoshi Fujisawa
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomohiro Terasaka
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takayuki Hara
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kanako Ogura-Ochi
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kenichi Inagaki
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Expression of Circulating Rennin-Angiotensin-Aldosterone-Related microRNAs in Patients with Thyrotoxic Heart Disease. Bull Exp Biol Med 2021; 172:125-132. [PMID: 34855075 DOI: 10.1007/s10517-021-05348-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Indexed: 10/19/2022]
Abstract
Thyrotoxic heart disease (THD) is a common and severe complication of hyperthyroidism and the etiology of this complication remains poorly understood. Activation of the rennin-angiotensin- aldosterone system by excess thyroxin is one of the major factors that contribute to the pathogenesis of THD. Several microRNAs such as miR-21, miR-155, miR-208a, and miR-499 are closely related to the rennin-angiotensin-aldosterone system and therefore should be involved in this process. Our study intends to explore whether these miRNAs are involved in the pathogenesis of THD, and if these miRNAs could be secreted into the circulation and serve as sentinel indicators for THD. Though there is a trend of elevation of miR- 155 in THD than in simple hyperthyroidism patients, we did not find statistically significant differences in the expression of these miRNAs in the blood of THD patients, but we found that miR-155 was significantly up-regulated in patients with Graves' disease with or without THD in comparison with healthy controls. Thus, miR-155 can serve as a novel biomarker for Graves' disease and can play important roles in pathogenesis of Graves' disease.
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14
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Eşme M, Bulur O, Atak MC, Balcı C, Dal K, Ertuğrul DT, Dikmen ZG, Halil MG, Cankurtaran M, Balam Doğu B. Treatment of hypothyroidism improves glomerular filtration rate (GFR) in geriatric patients. Turk J Med Sci 2021; 51:1267-1272. [PMID: 33705647 PMCID: PMC8283444 DOI: 10.3906/sag-2011-257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/11/2021] [Indexed: 11/28/2022] Open
Abstract
Background/aim Renal function of patients with hypothyroidism increases after reaching euthyroid state. There is no data regarding geriatric age group. The aim of the study was determined to investigate whether renal function of geriatric patients with hypothyroidism increases after they become euthyroid. Materials and methods Patients who were sixty-five years or older were retrospectively screened in two centers. TSH, T3, T4, creatinine, and eGFR calculated by CKD-EPI formula were recorded under the presence of accompanying hypothyroidism. The same variables were recorded after the patients became euthyroid. Results 285 patients were included in the study, the median age was 73(65–84), and 234 patients were female. Patients were examined in four groups according to TSH values. There were 160 (56.1%) patients with TSH 5–9.9 uIU/mL, 60(21.1%) patients with TSH between 10–19.9 uIU/mL, 41(14.4 %) patients with TSH between 20–49.9 uIU/mL and 24(8.4%) patients with TSH> 50uIU/mL. There was a significant and negative correlation between the initial TSH values and the first calculated eGFR values (p: 0.001; r: –0.191). The median eGFR of the patients in hypothyroid cases was 66.59 (14.62–116.07), while the median eGFR value of patients was 69.6 (12.91–109.31) in the euthyroid state. This value obtained after thyroid replacement was significantly improved when compared to the first eGFR (p: 0.001). In logistic regression analysis, pretreatment TSH value was found to independently affect eGFR (p: 0.009; Exb: 1.017). Conclusion It has been observed that hypothyroidism treatment increases eGFR in geriatric patients. Similar results were obtained after studies with younger patients in the literature. This study is a study in which only geriatric age group patients were examined. It should be kept in mind that hypothyroidism which is not corrected in geriatric patients may also contribute to a decrease in eGFR.
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Affiliation(s)
- Mert Eşme
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Oktay Bulur
- Department of Internal Medicine, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Mehmet Can Atak
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Cafer Balcı
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kürşat Dal
- Department of Internal Medicine, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Derun Taner Ertuğrul
- Department of Internal Medicine, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Zeliha Günnur Dikmen
- Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Meltem Gülhan Halil
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Cankurtaran
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu Balam Doğu
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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15
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Abstract
Hypothyroidism is a highly prevalent endocrine complication in chronic kidney disease (CKD) patients. A large body of evidence has shown that there is a bidirectional relationship between thyroid dysfunction and kidney disease, yet there are many remaining gaps in knowledge in regards to the clinical management of CKD patients with hypothyroidism, including those receiving hemodialysis and peritoneal dialysis. Given that hypothyroidism has been associated with many deleterious outcomes including a higher risk of (1) mortality, (2) cardiovascular disease, (3) impaired health-related quality of life, and (4) altered body composition in both non-CKD and CKD patients, future research is needed to establish the appropriate screening, diagnosis, and treatment approaches in these populations.
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Affiliation(s)
- Yoko Narasaki
- Harold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, CA
| | - Peter Sohn
- Harold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, CA
| | - Connie M Rhee
- Harold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, CA.
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16
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Damara FA, Muchamad GR, Ikhsani R, Hendro, Syafiyah AH, Bashari MH. Thyroid disease and hypothyroidism are associated with poor COVID-19 outcomes: A systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr 2021; 15:102312. [PMID: 34731819 PMCID: PMC8530797 DOI: 10.1016/j.dsx.2021.102312] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Coronavirus disease (COVID-19) still becomes a global burden that affected people in different groups. The aim of this study was to evaluate the association between thyroid disease and the outcome of COVID-19 patients. METHOD This was a meta-analysis study from articles obtained through a systematic literature search to investigate the relationship between thyroid disease and COVID-19 outcomes. Composite poor outcomes comprised of severity, mortality, intensive care unit (ICU) admission, and hospitalization. RESULTS A total of 31339 patients from 21 studies included in this study. Thyroid disorder was associated with increased composite poor outcome (risk ratio (RR) 1.87 [95% confidence interval (CI) 1.53, 2.27], p < 0.001; I2 = 84%, p < 0.01), this included higher disease severity (RR 1.92 [1.40, 2.63], p < 0.05; I2 = 86%, p < 0.01), ICU admission (RR 1.61 [1.12, 2.32], p > 0.05; I2 = 32%, p < 0.05), mortality (RR 2.43 [1.44, 4.13], p < 0.05; I2 = 83%, p < 0.01), and hospitalization (RR 1.28 [1.17, 1.39], p < 0.05; I2 = 0%, p < 0.96). Meta-regression analysis indicated that age (p = 0.002) was a significant influence that affects the association. Also, the presence of unspecified thyroid disease (RR 1.91 [1.38, 2.65], p < 0.05; I2 = 81%, p < 0.01) and hypothyroidism (RR 1.90 [1.45, 2.55], p < 0.05; I2 = 85%, p < 0.01) during admission were associated with poor outcomes. CONCLUSION Thyroid abnormalities increased the risk of COVID-19 composite poor outcomes and were influenced by the patient's age. Abnormal thyroid and hypothyroidism, but not hyperthyroidism, were associated with poor COVID-19 outcomes.
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Affiliation(s)
- Fachreza Aryo Damara
- Faculty of Medicine, Universitas Padjadjaran, Dr Hasan Sadikin Hospital, Bandung, Indonesia.
| | - Galih Ricci Muchamad
- Department of Medicine, Faculty of Medicine, Universitas Diponegoro, Kariadi General Hospital, Semarang, Indonesia
| | - Rizkania Ikhsani
- Faculty of Medicine, Universitas Padjadjaran, Dr Hasan Sadikin Hospital, Bandung, Indonesia
| | - Hendro
- Faculty of Medicine, Universitas Padjadjaran, Dr Hasan Sadikin Hospital, Bandung, Indonesia
| | - Anisa Hana Syafiyah
- Faculty of Medicine, Universitas Padjadjaran, Dr Hasan Sadikin Hospital, Bandung, Indonesia
| | - Muhammad Hasan Bashari
- Department Biomedical Sciences, Division of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, Indonesia
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Salamanna F, Maglio M, Landini MP, Fini M. Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2. Front Med (Lausanne) 2020; 7:594495. [PMID: 33344479 PMCID: PMC7744810 DOI: 10.3389/fmed.2020.594495] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/16/2020] [Indexed: 01/08/2023] Open
Abstract
The explosion of the new coronavirus (SARS-CoV-2) pandemic has brought the role of the angiotensin converting enzyme 2 (ACE2) back into the scientific limelight. Since SARS-CoV-2 must bind the ACE2 for entering the host cells in humans, its expression and body localization are critical to track the potential target organ of this infection and to outline disease progression and clinical outcomes. Here, we mapped the physiological body distribution, expression, and activities of ACE2 and discussed its potential correlations and mutal interactions with the disparate symptoms present in SARS-CoV-2 patients at the level of different organs. We highlighted that despite during SARS-CoV-2 infection ACE2-expressing organs may become direct targets, leading to severe pathological manifestations, and subsequent multiple organ failures, the exact mechanism and the potential interactions through which ACE2 acts in these organs is still heavily debated. Further scientific efforts, also considering a personalized approach aimed to consider specific patient differences in the mutual interactions ACE2-SARS-CoV-2 and the long-term health effects associated with COVID-19 are currently mandatory.
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Affiliation(s)
- Francesca Salamanna
- Surgical Sciences and Technologies, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Melania Maglio
- Surgical Sciences and Technologies, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Paola Landini
- Scientific Direction, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Milena Fini
- Surgical Sciences and Technologies, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Ortopedico Rizzoli, Bologna, Italy
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18
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Kumari K, Chainy GB, Subudhi U. Prospective role of thyroid disorders in monitoring COVID-19 pandemic. Heliyon 2020; 6:e05712. [PMID: 33344794 PMCID: PMC7733548 DOI: 10.1016/j.heliyon.2020.e05712] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/01/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 pandemic has affected more than 200 countries and 1.3 million individuals have deceased within eleven months. Intense research on COVID-19 occurrence and prevalence enable us to understand that comorbidities play a crucial role in spread and severity of SARS-CoV-2 infection. Chronic kidney disease, diabetes, respiratory diseases and hypertension are among the various morbidities that are prevalent in symptomatic COVID-19 patients. However, the effect of altered thyroid-driven disorders cannot be ignored. Since thyroid hormone critically coordinate and regulate the major metabolism and biochemical pathways, this review is on the potential role of prevailing thyroid disorders in SARS-CoV-2 infection. Direct link of thyroid hormone with several disorders such as diabetes, vitamin D deficiency, obesity, kidney and liver disorders etc. suggests that the prevailing thyroid conditions may affect SARS-CoV-2 infection. Further, we discuss the oxidative stress-induced aging is associated with the degree of SARS-CoV-2 infection. Importantly, ACE2 protein which facilitates the host-cell entry of SARS-CoV-2 using the spike protein, are highly expressed in individuals with abnormal level of thyroid hormone. Altogether, we report that the malfunction of thyroid hormone synthesis may aggravate SARS-CoV-2 infection and thus monitoring the thyroid hormone may help in understanding the pathogenesis of COVID-19.
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Affiliation(s)
- Kanchan Kumari
- CSIR-Institute of Minerals & Materials Technology, Bhubaneswar 751013, Odisha, India
- Department of Molecular Biology, Umea University, Sweden
| | - Gagan B.N. Chainy
- Post Graduate Department of Biotechnology, Utkal University, Bhubaneswar 751004, Odisha, India
| | - Umakanta Subudhi
- CSIR-Institute of Minerals & Materials Technology, Bhubaneswar 751013, Odisha, India
- Academy of Scientific & Innovative Research (AcSIR), New Delhi 110025, India
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19
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Khalili S, Moradi O, Kharazmi AB, Raoufi M, Sistanizad M, Shariat M. Comparison of Mortality Rate and Severity of Pulmonary Involvement in Coronavirus Disease-2019 Adult Patients With and Without Type 2 Diabetes: A Cohort Study. Can J Diabetes 2020; 45:524-530. [PMID: 33339741 PMCID: PMC7604035 DOI: 10.1016/j.jcjd.2020.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/15/2020] [Accepted: 10/25/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Patients with diabetes are potentially at higher risk of mortality due to coronavirus disease-2019 (COVID-19). In this study, we aimed to compare the outcomes and severity of pulmonary involvement in COVID-19 patients with and without diabetes. METHODS In this cohort study, we recruited patients with diabetes who were hospitalized due to COVID-19 during the period from February 2020 to May 2020. Hospitalized individuals without diabetes were enrolled as control subjects. All patients were followed for 90 days and clinical findings and patients' outcomes were reported. RESULTS Over a period of 4 months, 127 patients with diabetes and 127 individuals without diabetes with a diagnosis of COVID-19 were recruited. Their mean age was 65.70±12.51 years. Mortality was higher in the group with diabetes (22.8% vs 15.0%; p=0.109), although not significantly. More severe pulmonary involvement (p=0.015), extended hospital stay (p<0.001) and greater need for invasive ventilation (p=0.029) were reported in this population. Stepwise logistic regression revealed that diabetes was not independently associated with mortality (p=0.092). Older age (odds ratio [OR], 1.054; p=0.003), aggravated pulmonary involvement on admission (OR, 1.149; p=0.001), presence of comorbidities (OR, 1.290; p=0.020) and hypothyroidism (OR, 6.576; p=0.021) were associated with mortality. Diabetic foot infection had a strong positive correlation with mortality (OR, 49.819; p=0.016), whereas insulin therapy had a negative correlation (OR, 0.242; p=0.045). CONCLUSIONS The mortality rate due to COVID-19 did not differ significantly between patients with or without diabetes. Older age, macrovascular complications and presence of comorbidities could increase mortality in people with diabetes. Insulin therapy during hospitalization could attenuate the detrimental effects of hyperglycemia and improve prognosis of patients with COVID-19 and diabetes.
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Affiliation(s)
- Shayesteh Khalili
- Department of Internal Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Moradi
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Behnam Kharazmi
- Department of Internal Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoomeh Raoufi
- Department of Radiology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Sistanizad
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Prevention of Cardiovascular Disease Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Masoud Shariat
- Department of Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada
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20
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Greco M, Foti DP, Aversa A, Fuiano G, Brunetti A, Simeoni M. Cystatin C, a Controversial Biomarker in Hypothyroid Patients under Levothyroxine Therapy: THYRenal, a Pilot Cohort Observational Study. J Clin Med 2020; 9:E2958. [PMID: 32933111 PMCID: PMC7565550 DOI: 10.3390/jcm9092958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cystatin C (Cys-C) is recognized as one of the most reliable renal function parameters in the general population, although it might be biased by thyroid status. Herein, we tested Cys-C and conventional renal parameters in a cohort of hypothyroid patients treated with Levothyroxine. METHODS Eighty-four hypothyroid patients were recruited and subgrouped according to their serum thyroid-stimulating hormone (TSH) values as a paradigm for therapeutic targeting (n = 54, optimal TSH range = 0.5-2 µIU/mL; n = 30, TSH > 2µIU/mL). Serum Cys-C, creatinine, measured and estimated glomerular filtration rates (mGFR and eGFR) were assessed. Results-mGFR and eGFR were comparable among the two subgroups, whereas Cys-C was significantly higher in patients with suboptimal TSH values (>2 µIU/mL) (p < 0.0001). TSH significantly correlated with Cys-C in the overall patient group, and in the subgroup with TSH above the target value (>2 µIU/mL). Out of 20 patients with abnormal Cys-C, 19 had suboptimal TSH levels. Receiver operating characteristic (ROC) analysis indicated Cys-C as a moderately accurate diagnostic tool (AUC = 0.871) to assess Levothyroxine replacement efficacy in hypothyroid patients (63% sensitivity, and 98% specificity). CONCLUSIONS The observation of increased serum Cys-C in patients with suboptimal TSH would suggest the importance of a careful interpretation by clinicians of this biomarker in the case of hypothyroid patients.
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Affiliation(s)
- Marta Greco
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy; (M.G.); (D.P.F.)
| | - Daniela Patrizia Foti
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy; (M.G.); (D.P.F.)
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Giorgio Fuiano
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Antonio Brunetti
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy; (M.G.); (D.P.F.)
| | - Mariadelina Simeoni
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy;
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Effect of Thyroid Hormones on Kidney Function in Patients after Kidney Transplantation. Sci Rep 2020; 10:2156. [PMID: 32034263 PMCID: PMC7005730 DOI: 10.1038/s41598-020-59178-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 01/15/2020] [Indexed: 11/21/2022] Open
Abstract
Elevated levels of thyroid-stimulating-hormone (TSH) are associated with reduced glomerular filtration rate (GFR) and increased risk of developing chronic kidney disease even in euthyroid patients. Thyroid hormone replacement therapy has been shown to delay progression to end-stage renal disease in sub-clinically hypothyroid patients with renal insufficiency. However, such associations after kidney transplantation were never investigated. In this study the association of thyroid hormones and estimated GFR (eGFR) in euthyroid patients after kidney transplantation was analyzed. In total 398 kidney transplant recipients were assessed retrospectively and association between thyroid and kidney function parameters at and between defined time points, 12 and 24 months after transplantation, was studied. A significant inverse association was shown for TSH changes and eGFR over time between months 12 and 24 post transplantation. For each increase of TSH by 1 µIU/mL, eGFR decreased by 1.34 mL/min [95% CI, −2.51 to −0.16; p = 0.03], corresponding to 2.2% eGFR decline, within 12 months. At selected time points 12 and 24 months post transplantation, however, TSH was not associated with eGFR. In conclusion, an increase in TSH between 12 and 24 months after kidney transplantation leads to a significant decrease in eGFR, which strengthens the concept of a kidney-thyroid-axis.
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Barreto-Chaves MLM, Senger N, Fevereiro MR, Parletta AC, Takano APC. Impact of hyperthyroidism on cardiac hypertrophy. Endocr Connect 2020; 9:EC-19-0543.R1. [PMID: 32101527 PMCID: PMC7159257 DOI: 10.1530/ec-19-0543] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/25/2020] [Indexed: 12/14/2022]
Abstract
The cardiac growth process (hypertrophy) is a crucial phenomenon conserved across a wide array of species and it is critically involved in maintenance of cardiac homeostasis. This process enables organism adaptation to changes of systemic demand and occurs due to a plethora of responses, depending on the type of signal or stimuli received. The growth of cardiac muscle cells in response to environmental conditions depends on the type, strength and duration of stimuli, and results in adaptive physiologic response or non-adaptive pathologic response. Thyroid hormones (TH) have a direct effect on the heart and induce a cardiac hypertrophy phenotype, which may evolve to heart failure. In this review, we summarize the literature on TH function in heart presenting results from experimental studies. We discuss the mechanistic aspects of TH associated with cardiac myocyte hypertrophy, increased cardiac myocyte contractility and electrical remodeling as well as the signaling pathways associated. In addition to classical crosstalk with the Sympathetic Nervous System (SNS), emerging work points to the new endocrine interaction between TH and Renin-Angiotensin System (RAS) is also explored. Given the inflammatory potential of the angiotensin II peptide, this new interaction may open the door for new therapeutic approaches that target key mechanisms responsible for TH-induced cardiac hypertrophy.
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Affiliation(s)
- M L M Barreto-Chaves
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - N Senger
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - M R Fevereiro
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - A C Parletta
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - A P C Takano
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Liu J, Xue Y, Jiang W, Zhang H, Zhao Y. Thyroid Hormone Is Related to Postoperative AKI in Acute Type A Aortic Dissection. Front Endocrinol (Lausanne) 2020; 11:588149. [PMID: 33312160 PMCID: PMC7708335 DOI: 10.3389/fendo.2020.588149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/12/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Renal function is profoundly influenced by thyroid hormone levels. This study was designed to evaluate the association between preoperative thyroid hormones and postoperative acute kidney injury (AKI) in acute type A aortic dissection (ATAAD) patients. METHODS A total of 88 patients with ATAAD who underwent surgeries in Beijing Anzhen Hospital and 274 healthy controls from July 2016 to December 2016 were included in this study. Propensity-score matching was used to compare thyroid hormone levels. Additionally, in a cohort study of ATAAD patients, multivariable regression and stratification analyses were conducted to examine the association of preoperative thyroid hormones with postoperative AKI. RESULTS Compared with healthy controls, ATAAD patients presented with lower preoperative levels of total triiodothyronine (TT3) (P < 0.01), free triiodothyronine (FT3) (P < 0.01), and thyroid-stimulating hormone (TSH) (P < 0.01) and a higher preoperative level of free thyroxine (FT4) (P < 0.01). The overall occurrence of postoperative AKI was 45.5%. Multivariate regression revealed that low levels of TT3 (OR = 0.07, 95% CI, 0.01-0.86, P = 0.04) were independently associated with postoperative AKI. Subgroup analyses showed that the association between TT3 and AKI was significant in patients with normal TSH levels (OR = 0.001 95% CI, 0.001-0.16, P < 0.01) but not in patients with lower TSH levels (P = 0.12). CONCLUSION The present study showed that a low level of TT3 was a predictor of postoperative AKI in ATAAD patients, especially in patients with normal TSH. The thyroid function should be checked before surgical intervention of patients with ATAAD, and patients with low T3 might be at higher risk of postoperative AKI.
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Affiliation(s)
- Jihong Liu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
- Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
- Department of Cardiac Surgery, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yuan Xue
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
- Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
| | - Wenjian Jiang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
- Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
- *Correspondence: Hongjia Zhang, ; Wenjian Jiang, ; Yuanfei Zhao,
| | - Hongjia Zhang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
- Beijing Lab for Cardiovascular Precision Medicine, Beijing, China
- *Correspondence: Hongjia Zhang, ; Wenjian Jiang, ; Yuanfei Zhao,
| | - Yuanfei Zhao
- Centre for Transplant and Renal Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- *Correspondence: Hongjia Zhang, ; Wenjian Jiang, ; Yuanfei Zhao,
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Abstract
PURPOSE OF REVIEW Hypothyroidism is a highly prevalent endocrine disorder in the end-stage renal disease (ESRD) population, yet many cases may remain latent and undiagnosed. RECENT FINDINGS Epidemiologic data show that there is a nearly five-fold higher prevalence of hypothyroidism in advanced chronic kidney disease (CKD) patients vs. those without CKD. Given that the metabolism, degradation, and excretion of thyroid hormone and its metabolites, as well as the regulation of the hypothalamic-pituitary-thyroid axis may be altered in ESRD, certain considerations should be made when interpreting thyroid functional tests in these patients. Growing evidence shows that hypothyroidism and other thyroid functional test derangements are associated with higher risk of cardiovascular disease, worse patient-centered outcomes, and survival in the advanced CKD population, including those with ESRD. Although limited data examining treatment of hypothyroidism suggests benefit, further studies of the efficacy and safety of thyroid hormone supplementation, including clinical trials and rigorous longitudinal observational studies are needed to inform the management of thyroid dysfunction in CKD. SUMMARY Given the high burden of hypothyroidism in ESRD patients, and potential ill effects on their cardiovascular health, patient-centered outcomes, and survival, further research is needed to inform the optimal management of thyroid dysfunction in this population.
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Affiliation(s)
- Connie M. Rhee
- Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine School of Medicine, Orange, CA
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25
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Do AN, Zhao W, Baldridge AS, Raffield LM, Wiggins KL, Shah SJ, Aslibekyan S, Tiwari HK, Limdi N, Zhi D, Sitlani CM, Taylor KD, Psaty BM, Sotoodehnia N, Brody JA, Rasmussen‐Torvik LJ, Lloyd‐Jones D, Lange LA, Wilson JG, Smith JA, Kardia SLR, Mosley TH, Vasan RS, Arnett DK, Irvin MR. Genome-wide meta-analysis of SNP and antihypertensive medication interactions on left ventricular traits in African Americans. Mol Genet Genomic Med 2019; 7:e00788. [PMID: 31407531 PMCID: PMC6785453 DOI: 10.1002/mgg3.788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/14/2019] [Accepted: 04/22/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Left ventricular (LV) hypertrophy affects up to 43% of African Americans (AAs). Antihypertensive treatment reduces LV mass (LVM). However, interindividual variation in LV traits in response to antihypertensive treatments exists. We hypothesized that genetic variants may modify the association of antihypertensive treatment class with LV traits measured by echocardiography. METHODS We evaluated the main effects of the three most common antihypertensive treatments for AAs as well as the single nucleotide polymorphism (SNP)-by-drug interaction on LVM and relative wall thickness (RWT) in 2,068 participants across five community-based cohorts. Treatments included thiazide diuretics (TDs), angiotensin converting enzyme inhibitors (ACE-Is), and dihydropyridine calcium channel blockers (dCCBs) and were compared in a pairwise manner. We performed fixed effects inverse variance weighted meta-analyses of main effects of drugs and 2.5 million SNP-by-drug interaction estimates. RESULTS We observed that dCCBs versus TDs were associated with higher LVM after adjusting for covariates (p = 0.001). We report three SNPs at a single locus on chromosome 20 that modified the association between RWT and treatment when comparing dCCBs to ACE-Is with consistent effects across cohorts (smallest p = 4.7 × 10-8 , minor allele frequency range 0.09-0.12). This locus has been linked to LV hypertrophy in a previous study. A marginally significant locus in BICD1 (rs326641) was validated in an external population. CONCLUSIONS Our study identified one locus having genome-wide significant SNP-by-drug interaction effect on RWT among dCCB users in comparison to ACE-I users. Upon additional validation in future studies, our findings can enhance the precision of medical approaches in hypertension treatment.
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Affiliation(s)
- Anh N. Do
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Wei Zhao
- Department of EpidemiologyUniversity of MichiganAnn ArborMichiganUSA
| | | | - Laura M. Raffield
- Department of GeneticsUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Sanjiv J. Shah
- Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Stella Aslibekyan
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Hemant K. Tiwari
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Nita Limdi
- Department of NeurologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Degui Zhi
- School of Biomedical InformaticsUniversity of Texas Health Sciences Center at HoustonHoustonTexasUSA
| | - Colleen M. Sitlani
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Kent D. Taylor
- Department of Pediatrics, The Institute for Translational Genomics and Population SciencesLABioMed at Harbor‐UCLA Medical CenterSeattleWashingtonUSA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health ServicesUniversity of WashingtonSeattleWashingtonUSA
- Kaiser Permanente Washington Health Research InstituteSeattleWashingtonUSA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, Departments of Medicine and EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Jennifer A. Brody
- Cardiovascular Health Research Unit, Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Laura J. Rasmussen‐Torvik
- Department of Preventive Medicine Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | | | - Leslie A. Lange
- Department of MedicineUniversity of Colorado DenverAuroraColoradoUSA
| | - James G. Wilson
- Department of Physiology and BiophysicsUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Jennifer A. Smith
- Department of EpidemiologyUniversity of MichiganAnn ArborMichiganUSA
| | | | - Thomas H. Mosley
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Ramachandran S. Vasan
- Departments of Medicine and Preventive MedicineBoston University School of MedicineBostonMassachusettsUSA
| | - Donna K. Arnett
- College of Public HealthUniversity of KentuckyLexingtonKentuckyUSA
| | - Marguerite R. Irvin
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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Farhadi SAS, Dizaye KF. Aliskiren, Fosinopril, and Their Outcome on Renin-Angiotensin-Aldosterone System (RAAS) in Rats with Thyroid Dysfunction. Int J Endocrinol 2019; 2019:5960563. [PMID: 31396276 PMCID: PMC6668533 DOI: 10.1155/2019/5960563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/12/2019] [Accepted: 06/19/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Thyroid hormones have an important role in the growth and development of various tissues including the kidney, which is the major site of renin release and the consequent angiotensin and aldosterone formation. Therefore any derangement in thyroid function can result in abnormal functioning in the renin-angiotensin-aldosterone system. The current study was undertaken to find the impact of using a direct renin inhibitor (Aliskiren) and an angiotensin-converting enzyme inhibitor (Fosinopril) on the components of the renin-angiotensin-aldosterone system (RAAS) in rats with thyroid dysfunctions. METHOD Forty-two male albino rats were divided into three subgroups. First group (6 rats) served as control. Second group (18 rats) served as hyperthyroid group (6 rats positive control, 6 rats given Aliskiren, and 6 rats given Fosinopril). Third group (18 rats) served as hypothyroid group (6 rats positive control, 6 rats given Aliskiren, and 6 rats given Fosinopril). Induction of hyperthyroidism and hypothyroidism was done through daily oral administration of L-Thyroxine and Propylthiouracil, respectively. On day 40 of the study, the rats were sacrificed and blood was collected for estimation of renin, angiotensin I, angiotensin II, aldosterone, TSH, T3, and T4. The collected blood samples were also used for estimation of levels blood urea, serum creatinine, liver enzymes, and serum electrolytes. Blood pressure and urine collection were done on days 1 and 40. The collected urine was used for estimation of urine flow, sodium excretion, and potassium excretion rates. RESULTS In hypothyroid induced rats, serum renin level dropped as expected, while the use of Aliskiren and Fosinopril on these hypothyroid rats raised renin level due to the feedback mechanism. Both angiotensin I and II were significantly (P <0.05) lower than normal levels in the hypothyroid rats, unlike the level of aldosterone, which was higher than normal level. There was nonsignificant lowering in BP (systolic, diastolic, and mean BP) in the hypothyroid rats. Treatment of these rats with Aliskiren and Fosinopril did not lower the blood pressure more than normal when compared to the hypothyroid group. The hypothyroid rats also showed a decrease in level of serum creatinine. In hyperthyroid rats, there was a rise in levels of serum renin, angiotensin II, and aldosterone; nevertheless, the increase in angiotensin I level was significant. The use of Aliskiren and Fosinopril increased the level of renin nonsignificantly (decreased angiotensin I significantly). Hyperthyroid rats showed a significant increase in systolic, diastolic, and mean blood pressure. Both Aliskiren and Fosinopril increased urine flow, Na+ excretion, and K+ excretion rates. Aliskiren was better at reducing the high blood pressure. CONCLUSION Aliskiren and Fosinopril in hyperthyroid rats decreased serum angiotensin I, angiotensin II, and aldosterone. Blockade of renin and inhibition of angiotensin-converting enzyme both resulted in a rebound increase in level of renin in hypothyroid rats. Aliskiren is better at controlling blood pressure in hyperthyroid rats. Urine flow, sodium excretion, and potassium excretion rates were improved by the use of Aliskiren and Fosinopril in hyperthyroid rats.
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Affiliation(s)
- Susan A. S. Farhadi
- Department of Basic Sciences/ Pharmacology Unit, College of Medicine, Hawler Medical University, Erbil, Iraq
| | - Kawa F. Dizaye
- Department of Basic Sciences/ Pharmacology Unit, College of Medicine, Hawler Medical University, Erbil, Iraq
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Segarra AB, Prieto I, Martínez-Cañamero M, de Gasparo M, Luna JDD, Ramírez-Sánchez M. Thyroid Disorders Change the Pattern of Response of Angiotensinase Activities in the Hypothalamus-Pituitary-Adrenal Axis of Male Rats. Front Endocrinol (Lausanne) 2018; 9:731. [PMID: 30555423 PMCID: PMC6283893 DOI: 10.3389/fendo.2018.00731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/16/2018] [Indexed: 11/17/2022] Open
Abstract
Thyroid disorders affect the hypothalamic-pituitary-adrenal axis with important consequences on the cardiovascular function in which the renin-angiotensin system plays a major role. Hypo and hyperthyroidism influence the classic main components of the renin-angiotensin system. However, the behavior of other elements of the renin-angiotensin system such as Ang III, Ang 2-10, Ang IV, or AT4, regulated by angiotensinase enzymes such as alanyl- (AlaAP), cystinyl- (CysAP), glutamyl- (GluAP), or aspartyl-aminopeptidase (AspAP), has not yet been described. In order to obtain a comprehensive view on the response of the renin-angiotensin system in the hypothalamic-pituitary-adrenal axis of animals with thyroid disorders, these enzyme activities were simultaneously analyzed fluorometrically, using arylamide derivatives as substrates in hypothalamus, anterior and posterior pituitary, adrenals and plasma of euthyroid, hypothyroid, and hyperthyroid rats, and their intra- and inter-tissue correlations were evaluated. The response is depending on the type of enzyme studied, its location and the thyroid status. Anterior pituitary, adrenals and plasma were mainly affected by the thyroid disorders. In the anterior pituitary, GluAP and AspAP increased in hypothyroid rats. In adrenals, AlaAP and CysAP decreased in hypothyroid whereas GluAP and AspAP decreased in hyperthyroid rats. In plasma, while AlaAP increased in hypo- and hyperthyroid rats, CysAP and GluAP decreased only in hyperthyroid. In comparison with euthyroid, intra-tissue correlations decreased in hypothyroid but inter-tissue correlations decreased mainly in hyperthyroid rats. Thyroid disorders also produced a disruption in the pattern of inter-tissue correlations observed in euthyroid. These results suggest that thyroid hormone levels hit components of the renin-angiotensin system and may influence the paracrine and endocrine cross talk between cells.
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Affiliation(s)
- Ana B. Segarra
- Department of Health Sciences, University of Jaén, Jaén, Spain
| | - Isabel Prieto
- Department of Health Sciences, University of Jaén, Jaén, Spain
| | | | - Marc de Gasparo
- Cardiovascular and Metabolic Syndrome Adviser, Rossemaison, Switzerland
| | - Juan de Dios Luna
- Department of Biostatistics, Medical School, University of Granada, Granada, Spain
| | - Manuel Ramírez-Sánchez
- Department of Health Sciences, University of Jaén, Jaén, Spain
- *Correspondence: Manuel Ramírez-Sánchez
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AT1 receptor blockage impairs NF-κB activation mediated by thyroid hormone in cardiomyocytes. Pflugers Arch 2017; 470:549-558. [DOI: 10.1007/s00424-017-2088-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 11/06/2017] [Accepted: 11/15/2017] [Indexed: 10/18/2022]
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Gunatilake SSC, Bulugahapitiya U. Coexistence of Primary Hyperaldosteronism and Graves' Disease, a Rare Combination of Endocrine Disorders: Is It beyond a Coincidence-A Case Report and Review of the Literature. Case Rep Endocrinol 2017; 2017:4050458. [PMID: 29214084 PMCID: PMC5682893 DOI: 10.1155/2017/4050458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 09/10/2017] [Accepted: 10/08/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Primary hyperaldosteronism is a known cause for secondary hypertension. In addition to its effect on blood pressure, aldosterone exhibits proinflammatory actions and plays a role in immunomodulation/development of autoimmunity. Recent researches also suggest significant thyroid dysfunction among patients with hyperaldosteronism, but exact causal relationship is not established. Autoimmune hyperthyroidism (Graves' disease) and primary hyperaldosteronism rarely coexist but underlying mechanisms associating the two are still unclear. CASE PRESENTATION A 32-year-old Sri Lankan female was evaluated for new onset hypertension in association with hypokalemia. She also had features of hyperthyroidism together with high TSH receptor antibodies suggestive of Graves' disease. On evaluation of persistent hypokalemia and hypertension, primary hyperaldosteronism due to right-sided adrenal adenoma was diagnosed. She was rendered euthyroid with antithyroid drugs followed by right-sided adrenalectomy. Antithyroid drugs were continued up to 12 months, after which the patient entered remission of Graves' disease. CONCLUSION Autoimmune hyperthyroidism and primary hyperaldosteronism rarely coexist and this case report adds to the limited number of cases documented in the literature. Underlying mechanism associating the two is still unclear but possibilities of autoimmune mechanisms and autoantibodies warrant further evaluation and research.
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Affiliation(s)
- S. S. C. Gunatilake
- Department of Endocrinology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka
| | - U. Bulugahapitiya
- Department of Endocrinology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka
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Lim G, Park HD, Sung HJ. A Correlation Analysis of Serum Creatinine Based eGFR and Serum Cystatin C Based eGFR with Thyroid Dysfunction Patients. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2017. [DOI: 10.15324/kjcls.2017.49.3.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Gu Lim
- Department of Biomedical Laboratory Sciences, College of Health Science, Eulji University, Seongnam, Korea
- BK21 Plus Program, Department of Senior Healthcare, Graduate School, Eulji University, Daejeon, Korea
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung-Doo Park
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho Joong Sung
- Department of Biomedical Laboratory Sciences, College of Health Science, Eulji University, Seongnam, Korea
- BK21 Plus Program, Department of Senior Healthcare, Graduate School, Eulji University, Daejeon, Korea
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Patel S, Rauf A, Khan H, Abu-Izneid T. Renin-angiotensin-aldosterone (RAAS): The ubiquitous system for homeostasis and pathologies. Biomed Pharmacother 2017; 94:317-325. [PMID: 28772209 DOI: 10.1016/j.biopha.2017.07.091] [Citation(s) in RCA: 325] [Impact Index Per Article: 46.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/10/2017] [Accepted: 07/19/2017] [Indexed: 12/22/2022] Open
Abstract
Renin-angiotensin-aldosterone system (RAAS) is a vital system of human body, as it maintains plasma sodium concentration, arterial blood pressure and extracellular volume. Kidney-secreted renin enzyme acts on its substrate to form angiotensin II, a versatile effector peptide hormone. Every organ is affected by RAAS activation and the resultant hypertension, cell proliferation, inflammation, and fibrosis. The imbalance of renin and angiotensin II can result in an overwhelming number of chronic and acute diseases. RAAS is influenced by other enzymes, hormones, pumps and signaling pathways, hence, this review discusses important facets of this system, its crosstalk with other crucial factors like estrogen, thyroid, cortisol, kallikrein-kinin system, Wnt/β-catenin signaling, and sodium-potassium pump. The nexus of RAAS with the above-discussed systems was scantily explored before. So, this review furnishes a new perspective in comprehension of inflammation diseases. It is followed by the formulation of hypotheses, which can contribute to better management of an array of pathologies plaguing mankind. Manipulation of RAAS, by bending it towards ACE2 expression can regulate endocrine functions, which can be critical for a number of pathological management. Dietary intervention can restore RAAS to normalcy.
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Affiliation(s)
- Seema Patel
- Bioinformatics and Medical Informatics Research Center, San Diego State University, San Diego, 92182, USA.
| | - Abdur Rauf
- Department of Chemistry, University of Swabi, Anbar-23561, Khyber Pakhtunkhwa, Pakistan.
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan, 23200, Pakistan
| | - Tareq Abu-Izneid
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Umm Al-Qura University, Makkah, P.O. Box 42, Saudi Arabia
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Than A, Xu S, Li R, Leow MKS, Sun L, Chen P. Angiotensin type 2 receptor activation promotes browning of white adipose tissue and brown adipogenesis. Signal Transduct Target Ther 2017; 2:17022. [PMID: 29263921 PMCID: PMC5661636 DOI: 10.1038/sigtrans.2017.22] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/29/2017] [Accepted: 03/31/2017] [Indexed: 01/06/2023] Open
Abstract
Brown adipose tissue dissipates energy in the form of heat. Recent studies have shown that adult humans possess both classical brown and beige adipocytes (brown-like adipocytes in white adipose tissue, WAT), and stimulating brown and beige adipocyte formation can be a new avenue to treat obesity. Angiotensin II (AngII) is a peptide hormone that plays important roles in energy metabolism via its angiotensin type 1 or type 2 receptors (AT1R and AT2R). Adipose tissue is a major source of AngII and expresses both types of its receptors, implying the autocrine and paracrine role of AngII in regulating adipose functions and self-remodeling. Here, based on the in vitro studies on primary cultures of mouse white adipocytes, we report that, AT2R activation, either by AngII or AT2R agonist (C21), induces white adipocyte browning, by increasing PPARγ expression, at least in part, via ERK1/2, PI3kinase/Akt and AMPK signaling pathways. It is also found that AngII–AT2R enhances brown adipogenesis. In the in vivo studies on mice, administration of AT1R antagonist (ZD7155) or AT2R agonist (C21) leads to the increase of WAT browning, body temperature and serum adiponectin, as well as the decrease of WAT mass and the serum levels of TNFα, triglycerides and free fatty acids. In addition, AT2R-induced browning effect is also observed in human white adipocytes, as evidenced by the increased UCP1 expression and oxygen consumption. Finally, we provide evidence that AT2R plays important roles in hormone T3-induced white adipose browning. This study, for the first time, reveals the browning and brown adipogenic effects of AT2R and suggests a potential therapeutic target to combat obesity and related metabolic disorders.
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Affiliation(s)
- Aung Than
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore
| | - Shaohai Xu
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore.,Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Ru Li
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore
| | | | - Lei Sun
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Peng Chen
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore
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Abstract
Thyroid hormones influence renal development, kidney hemodynamics, glomerular filtration rate and sodium and water homeostasis. Hypothyroidism and hyperthyroidism affect renal function by direct renal effects as well as systemic hemodynamic, metabolic and cardiovascular effects. Hypothyroidism has been associated with increased serum creatinine and decreased glomerular filtration rate. The reverse effects have been reported in thyrotoxicosis. Most of renal manifestations of thyroid dysfunction are reversible with treatment. Kidney disease may also cause thyroid dysfunction by several mechanisms. Nephrotic syndrome has been associated to changes in serum thyroid hormone concentrations. Different forms of glomerulonephritis and tubulointerstitial disease may be linked to thyroid derangements. A high prevalence of thyroid hormone alteration has been reported in acute kidney injury. Thyroid dysfunction is highly prevalent in chronic kidney disease patients. Subclinical hypothyroidism and low triiodothyronine syndrome are common features in patients with chronic kidney disease. Patients treated by both hemodialysis and peritoneal dialysis, and renal transplantation recipients, exhibit thyroid hormone alterations and thyroid disease with higher frequency than that found in the general population. Drugs used in the therapy of thyroid disease may lead to renal complications and, similarly, drugs used in kidney disorders may be associated to thyroid alterations. Lastly, low thyroid hormones, especially low triiodothyronine levels, in patients with chronic kidney disease have been related to a higher risk of cardiovascular disease and all-cause mortality. Interpretation of the interactions between thyroid and renal function is a challenge for clinicians involved in the treatment of patients with thyroid and kidney disease.
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Affiliation(s)
- Pedro Iglesias
- Department of Endocrinology, Hospital Ramón y Cajal, Ctra. De Colmenar, Km 9,100, 28034, Madrid, Spain.
| | - María Auxiliadora Bajo
- Department of Nephrology, Hospital La Paz, Madrid, Spain
- Department of Health Sciences, Universidad Autónoma de Madrid, Madrid, Spain
| | - Rafael Selgas
- Department of Nephrology, Hospital La Paz, Madrid, Spain
- Department of Health Sciences, Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan José Díez
- Department of Endocrinology, Hospital Ramón y Cajal, Ctra. De Colmenar, Km 9,100, 28034, Madrid, Spain
- Department of Medicine, University de Alcalá de Henares, Madrid, Spain
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Chaker L, Sedaghat S, Hoorn EJ, Elzen WPJD, Gussekloo J, Hofman A, Ikram MA, Franco OH, Dehghan A, Peeters RP. The association of thyroid function and the risk of kidney function decline: a population-based cohort study. Eur J Endocrinol 2016; 175:653-660. [PMID: 27926474 DOI: 10.1530/eje-16-0537] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/02/2016] [Accepted: 09/29/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Thyroid dysfunction has been associated with kidney function decline, but mainly in cross-sectional studies. Therefore, we aimed to determine the association between thyroid and kidney function in a prospective population-based cohort study longitudinally. DESIGN Prospective cohort study. METHODS Participants aged ≥45 years from the Rotterdam Study with thyroid and kidney function assessment were included. Kidney function and new onset chronic kidney disease (CKD) were defined using estimated glomerular filtration ate (eGFR), with CKD defined as eGFR <60 mL/min/1.73 m2 according to the CKD-EPI formula. RESULTS We included 5103 participants (mean age of 63.6 years) with a mean follow-up of 8.1 years. Cross-sectionally, higher TSH levels were associated with lower eGFR (Beta (β): -1.75 mL/min; 95% confidence interval (CI): -2.17, -1.33), in multivariable models adjusting for several cardiovascular risk factors including smoking, hypertension and history of coronary heart disease among others. In contrast, longitudinally, higher TSH levels were associated with less annual eGFR decline (β: -0.06 mL/min; CI: -0.11, -0.01) and lower CKD incidence (odds ratio 0.85, CI; 0.75, 0.96). Compared with euthyroid participants, subclinical hyperthyroid individuals had an increased risk for CKD whereas hypothyroid individuals had a decreased risk (P for trend = 0.04). CONCLUSIONS Hyperactive thyroid function is associated with increased risk of kidney function decline while hypothyroidism is associated with a decreased CKD risk. More insight is needed in the pathophysiological pathways connecting high thyroid function and kidney function decline.
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Affiliation(s)
- Layal Chaker
- Rotterdam Thyroid Center
- Department of Internal Medicine
- Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands
| | - Sanaz Sedaghat
- Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | - Jacobijn Gussekloo
- Department of Public Health and Primary CareLeiden University Medical Center, Leiden, The Netherlands
| | - Albert Hofman
- Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands
- Harvard T H Chan School of Public HealthBoston, Massachusetts, USA
| | - M Arfan Ikram
- Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands
- Department of NeurologyErasmus University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands
| | - Abbas Dehghan
- Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands
| | - Robin P Peeters
- Rotterdam Thyroid Center
- Department of Internal Medicine
- Department of EpidemiologyErasmus University Medical Center, Rotterdam, The Netherlands
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Stavreva DA, Varticovski L, Levkova L, George AA, Davis L, Pegoraro G, Blazer V, Iwanowicz L, Hager GL. Novel cell-based assay for detection of thyroid receptor beta-interacting environmental contaminants. Toxicology 2016; 368-369:69-79. [PMID: 27528272 PMCID: PMC5069182 DOI: 10.1016/j.tox.2016.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 07/02/2016] [Accepted: 08/11/2016] [Indexed: 12/16/2022]
Abstract
Even though the presence of endocrine disrupting chemicals (EDCs) with thyroid hormone (TH)-like activities in the environment is a major health concern, the methods for their efficient detection and monitoring are still limited. Here we describe a novel cell assay, based on the translocation of a green fluorescent protein (GFP)-tagged chimeric molecule of glucocorticoid receptor (GR) and the thyroid receptor beta (TRβ) from the cytoplasm to the nucleus in the presence of TR ligands. Unlike the constitutively nuclear TRβ, this GFP-GR-TRβ chimera is cytoplasmic in the absence of hormone while translocating to the nucleus in a time- and concentration-dependent manner upon stimulation with triiodothyronine (T3) and thyroid hormone analogue, TRIAC, while the reverse triiodothyronine (3,3',5'-triiodothyronine, or rT3) was inactive. Moreover, GFP-GR-TRβ chimera does not show any cross-reactivity with the GR-activating hormones, thus providing a clean system for the screening of TR beta-interacting EDCs. Using this assay, we demonstrated that Bisphenol A (BPA) and 3,3',5,5'-Tetrabromobisphenol (TBBPA) induced GFP-GR-TRβ translocation at micro molar concentrations. We screened over 100 concentrated water samples from different geographic locations in the United States and detected a low, but reproducible contamination in 53% of the samples. This system provides a novel high-throughput approach for screening for endocrine disrupting chemicals (EDCs) interacting with TR beta.
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Affiliation(s)
- Diana A Stavreva
- Laboratory of Receptor Biology and Gene Expression, Building 41, B602, 41 Library Dr., National Cancer Institute, NIH, Bethesda, MD 20892-5055, United States.
| | - Lyuba Varticovski
- Laboratory of Receptor Biology and Gene Expression, Building 41, B602, 41 Library Dr., National Cancer Institute, NIH, Bethesda, MD 20892-5055, United States
| | - Ludmila Levkova
- Department of Physics and Astronomy, Physics and Astronomy, University of Utah, Salt Lake City, UT, United States
| | - Anuja A George
- Laboratory of Receptor Biology and Gene Expression, Building 41, B602, 41 Library Dr., National Cancer Institute, NIH, Bethesda, MD 20892-5055, United States
| | - Luke Davis
- Laboratory of Receptor Biology and Gene Expression, Building 41, B602, 41 Library Dr., National Cancer Institute, NIH, Bethesda, MD 20892-5055, United States
| | - Gianluca Pegoraro
- Laboratory of Receptor Biology and Gene Expression, Building 41, B602, 41 Library Dr., National Cancer Institute, NIH, Bethesda, MD 20892-5055, United States
| | - Vicki Blazer
- U.S. Geological Survey, Leetown Science Center, National Fish Health Research Laboratory, 11649 Leetown Road, Kearneysville, WV 25430, United States
| | - Luke Iwanowicz
- U.S. Geological Survey, Leetown Science Center, National Fish Health Research Laboratory, 11649 Leetown Road, Kearneysville, WV 25430, United States
| | - Gordon L Hager
- Laboratory of Receptor Biology and Gene Expression, Building 41, B602, 41 Library Dr., National Cancer Institute, NIH, Bethesda, MD 20892-5055, United States.
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Hassanpour H, Afzali A, Fatemi Tabatabaie R, Torabi M, Alavi Y. Cardiac renin-angiotensin system (gene expression) and plasma angiotensin II in chickens with T3-induced pulmonary hypertension. Br Poult Sci 2016; 57:444-50. [DOI: 10.1080/00071668.2016.1162284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- H. Hassanpour
- Department of Basic Sciences (Physiology Division), Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
| | - A. Afzali
- Department of Basic Sciences (Physiology Division), Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
| | | | - M. Torabi
- Department of Physiology, Faculty of Veterinary Medicine, Shahid Chamran University, Ahvaz, Iran
| | - Y. Alavi
- Department of Basic Sciences (Physiology Division), Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
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Cardioprotective effects of lipoic acid, quercetin and resveratrol on oxidative stress related to thyroid hormone alterations in long-term obesity. J Nutr Biochem 2016; 33:36-44. [DOI: 10.1016/j.jnutbio.2016.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 02/15/2016] [Accepted: 02/23/2016] [Indexed: 12/20/2022]
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Simeoni M, Cerantonio A, Pastore I, Liguori R, Greco M, Foti D, Gulletta E, Brunetti A, Fuiano G. The correct renal function evaluation in patients with thyroid dysfunction. J Endocrinol Invest 2016; 39:495-507. [PMID: 26511999 DOI: 10.1007/s40618-015-0402-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 10/17/2015] [Indexed: 10/22/2022]
Abstract
Thyroid dysfunction induces several renal derangements involving all nephron portions. Furthermore, dysthyroidism is a recognized risk factor associated with the development of chronic kidney disease. Current data, in fact, demonstrate that either subclinical or overt thyroid disease is associated with significant changes in creatinine, estimated glomerular filtration rate, measured glomerular filtration rate and Cystatin C. Herein, we systematically reviewed several relevant studies aiming at the identification of the most sensitive and specific parameter for the correct renal function evaluation in patients with thyroid dysfunction, that are usually treated as outpatients. Our systematic review indicates that estimated glomerular filtration rate, preferably with CKD-EPI equation, appears to be the most reliable and wieldy renal function parameter. Instead, Cystatin C should be better used in the grading of thyroid dysfunction severity.
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Affiliation(s)
- Mariadelina Simeoni
- Nephrology and Dialysis Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy.
- University Campus 'Magna Graecia', Viale Europa-Loc. Germaneto, 88100, Catanzaro, Italy.
| | - Annamaria Cerantonio
- Nephrology and Dialysis Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy
| | - Ida Pastore
- Endocrinology Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy
| | - Rossella Liguori
- Endocrinology Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy
| | - Marta Greco
- Clinical Pathology Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy
| | - Daniela Foti
- Clinical Pathology Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy
| | - Elio Gulletta
- Clinical Pathology Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy
| | - Antonio Brunetti
- Clinical Pathology Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy
| | - Giorgio Fuiano
- Nephrology and Dialysis Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy
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Rodríguez-Gómez I, Moliz JN, Quesada A, Montoro-Molina S, Vargas-Tendero P, Osuna A, Wangensteen R, Vargas F. L-Arginine metabolism in cardiovascular and renal tissue from hyper- and hypothyroid rats. Exp Biol Med (Maywood) 2015; 241:550-6. [PMID: 26674221 DOI: 10.1177/1535370215619042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 10/27/2015] [Indexed: 12/31/2022] Open
Abstract
This study assessed the effects of thyroid hormones on the enzymes involved in l-arginine metabolism and the metabolites generated by the different metabolic pathways. Compounds of l-arginine metabolism were measured in the kidney, heart, aorta, and liver of euthyroid, hyperthyroid, and hypothyroid rats after 6 weeks of treatment. Enzymes studied were NOS isoforms (neuronal [nNOS], inducible [iNOS], and endothelial [eNOS]), arginases I and II, ornithine decarboxylase (ODC), ornithine aminotransferase (OAT), and l-arginine decarboxylase (ADC). Metabolites studied were l-arginine, l-citrulline, spermidine, spermine, and l-proline. Kidney heart and aorta levels of eNOS and iNOS were augmented and reduced (P < 0.05, for each tissue and enzyme) in hyper- and hypothyroid rats, respectively. Arginase I abundance in aorta, heart, and kidney was increased (P < 0.05, for each tissue) in hyperthyroid rats and was decreased in kidney and aorta of hypothyroid rats (P < 0.05, for each tissue). Arginase II was augmented in aorta and kidney (P < 0.05, for each tissue) of hyperthyroid rats and remained unchanged in all organs of hypothyroid rats. The substrate for these enzymes, l-arginine, was reduced (P < 0.05, for all tissues) in hyperthyroid rats. Levels of ODC and spermidine, its product, were increased and decreased (P < 0.05) in hyper- and hypothyroid rats, respectively, in all organs studied. OAT and proline levels were positively modulated by thyroid hormones in liver but not in the other tissues. ADC protein levels were positively modulated by thyroid hormones in all tissues. According to these findings, thyroid hormone treatment positively modulates different l-arginine metabolic pathways. The changes recorded in the abundance of eNOS, arginases I and II, and ADC protein in renal and cardiovascular tissues may play a role in the hemodynamic and renal manifestations observed in thyroid disorders. Furthermore, the changes in ODC and spermidine might contribute to the changes in cardiac and renal mass observed in thyroid disorders.
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Affiliation(s)
- Isabel Rodríguez-Gómez
- Instituto de Investigación Biosanitaria ibs. Granada 18012, Spain. Hospitales Universitarios de Granada. Universidad de Granada, Granada 18012, Spain
| | - Juan N Moliz
- Departamento de Fisiología, Facultad de Medicina, Grenada 18012, Spain
| | - Andrés Quesada
- Centro de Instrumentación Científica de la Universidad de Granada, Granada 18003, Spain
| | | | - Pablo Vargas-Tendero
- Instituto de Investigación Biosanitaria ibs. Granada 18012, Spain. Hospitales Universitarios de Granada. Universidad de Granada, Granada 18012, Spain
| | - Antonio Osuna
- Instituto de Investigación Biosanitaria ibs. Granada 18012, Spain. Hospitales Universitarios de Granada. Universidad de Granada, Granada 18012, Spain
| | - Rosemary Wangensteen
- Centro de Instrumentación Científica de la Universidad de Granada, Granada 18003, Spain
| | - Félix Vargas
- Instituto de Investigación Biosanitaria ibs. Granada 18012, Spain. Hospitales Universitarios de Granada. Universidad de Granada, Granada 18012, Spain
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Ferreira A, Sottiaux J, Mandara MT, Motta L. Ascending haemorrhagic myelomalacia associated with systemic hypertension in a hyperthyroid cat. JFMS Open Rep 2015; 1:2055116915589840. [PMID: 28491365 PMCID: PMC5362925 DOI: 10.1177/2055116915589840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2015] [Indexed: 12/30/2022] Open
Abstract
CASE SUMMARY An 8-year-old domestic shorthair neutered male cat was presented with acute onset of paraplegia, absent nociception on the pelvic limbs, tail and perianal area, and a previous history of uncontrolled hyperthyroidism (even after thyroidectomy) and chronic hypertension. The magnetic resonance findings (heterogeneous intramedullary ill-defined area, isointense on T1-weighted and hyperintense on short tau inversion recovery and T2-weighted scans between T12 and L5 spinal cord segments) were consistent with ascending haemorrhagic myelomalacia, which was confirmed by histopathology. It also revealed myelomalacia associated with diffuse arteriolar hyalinosis, similar to the reports found with hypertensive encephalopathy. RELEVANCE AND NOVEL INFORMATION Myelomalacia should be considered as a possible outcome in cats with hypertension. Considering that hypertension is a common consequence of hyperthyroidism, emphasis should be given to blood pressure monitoring, especially after treatment of this condition. We describe the histopathological changes occurring in the spinal cord associated with a state of hypertension.
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Affiliation(s)
| | - Jacques Sottiaux
- Cardiology Department, Grange Pierre, Saint Andre de Corcy, France
| | | | - Luca Motta
- ChesterGates Veterinary Specialists, Neurology Department, Chester, UK
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Rhee CM, Brent GA, Kovesdy CP, Soldin OP, Nguyen D, Budoff MJ, Brunelli SM, Kalantar-Zadeh K. Thyroid functional disease: an under-recognized cardiovascular risk factor in kidney disease patients. Nephrol Dial Transplant 2015; 30:724-37. [PMID: 24574542 PMCID: PMC4425477 DOI: 10.1093/ndt/gfu024] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 01/17/2014] [Indexed: 01/07/2023] Open
Abstract
Thyroid functional disease, and in particular hypothyroidism, is highly prevalent among chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. In the general population, hypothyroidism is associated with impaired cardiac contractility, endothelial dysfunction, atherosclerosis and possibly higher cardiovascular mortality. It has been hypothesized that hypothyroidism is an under-recognized, modifiable risk factor for the enormous burden of cardiovascular disease and death in CKD and ESRD, but this has been difficult to test due to the challenge of accurate thyroid functional assessment in uremia. Low thyroid hormone levels (i.e. triiodothyronine) have been associated with adverse cardiovascular sequelae in CKD and ESRD patients, but these metrics are confounded by malnutrition, inflammation and comorbid states, and hence may signify nonthyroidal illness (i.e. thyroid functional test derangements associated with underlying ill health in the absence of thyroid pathology). Thyrotropin is considered a sensitive and specific thyroid function measure that may more accurately classify hypothyroidism, but few studies have examined the clinical significance of thyrotropin-defined hypothyroidism in CKD and ESRD. Of even greater uncertainty are the risks and benefits of thyroid hormone replacement, which bear a narrow therapeutic-to-toxic window and are frequently prescribed to CKD and ESRD patients. In this review, we discuss mechanisms by which hypothyroidism adversely affects cardiovascular health; examine the prognostic implications of hypothyroidism, thyroid hormone alterations and exogenous thyroid hormone replacement in CKD and ESRD; and identify areas of uncertainty related to the interplay between hypothyroidism, cardiovascular disease and kidney disease requiring further investigation.
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Affiliation(s)
- Connie M. Rhee
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
| | - Gregory A. Brent
- Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Csaba P. Kovesdy
- Division of Nephrology, Memphis Veterans Affairs Medical Center, Memphis, TN, USA
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Offie P. Soldin
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Danh Nguyen
- Department of Medicine, University of California Irvine, Orange, CA, USA
| | - Matthew J. Budoff
- Division of Cardiology, LA Biomedical Research Institute, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Steven M. Brunelli
- Division of Nephrology, Brigham and Women's Hospital, Boston, MA, USA
- DaVita Clinical Research, Minneapolis, MN, USA
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA
- Department of Medicine, University of California Irvine, Orange, CA, USA
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA
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O’Donnell E, Goodman JM, Mak S, Murai H, Morris BL, Floras JS, Harvey PJ. Discordant Orthostatic Reflex Renin–Angiotensin and Sympathoneural Responses in Premenopausal Exercising-Hypoestrogenic Women. Hypertension 2015; 65:1089-95. [DOI: 10.1161/hypertensionaha.114.04976] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/19/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Emma O’Donnell
- From the Cardiovascular Research Laboratory, Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada (E.O’D., J.M.G.); and Department of Medicine, Division of Cardiology, University Health Network at Mount Sinai Hospital (J.M.G., S.M., H.M., B.L.M, J.S.F.), and Department of Medicine, Division of Cardiology at the Women’s College Hospital (P.J.H.), University of Toronto, Ontario, Canada
| | - Jack M. Goodman
- From the Cardiovascular Research Laboratory, Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada (E.O’D., J.M.G.); and Department of Medicine, Division of Cardiology, University Health Network at Mount Sinai Hospital (J.M.G., S.M., H.M., B.L.M, J.S.F.), and Department of Medicine, Division of Cardiology at the Women’s College Hospital (P.J.H.), University of Toronto, Ontario, Canada
| | - Susanna Mak
- From the Cardiovascular Research Laboratory, Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada (E.O’D., J.M.G.); and Department of Medicine, Division of Cardiology, University Health Network at Mount Sinai Hospital (J.M.G., S.M., H.M., B.L.M, J.S.F.), and Department of Medicine, Division of Cardiology at the Women’s College Hospital (P.J.H.), University of Toronto, Ontario, Canada
| | - Hisayoshi Murai
- From the Cardiovascular Research Laboratory, Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada (E.O’D., J.M.G.); and Department of Medicine, Division of Cardiology, University Health Network at Mount Sinai Hospital (J.M.G., S.M., H.M., B.L.M, J.S.F.), and Department of Medicine, Division of Cardiology at the Women’s College Hospital (P.J.H.), University of Toronto, Ontario, Canada
| | - Beverley L. Morris
- From the Cardiovascular Research Laboratory, Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada (E.O’D., J.M.G.); and Department of Medicine, Division of Cardiology, University Health Network at Mount Sinai Hospital (J.M.G., S.M., H.M., B.L.M, J.S.F.), and Department of Medicine, Division of Cardiology at the Women’s College Hospital (P.J.H.), University of Toronto, Ontario, Canada
| | - John S. Floras
- From the Cardiovascular Research Laboratory, Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada (E.O’D., J.M.G.); and Department of Medicine, Division of Cardiology, University Health Network at Mount Sinai Hospital (J.M.G., S.M., H.M., B.L.M, J.S.F.), and Department of Medicine, Division of Cardiology at the Women’s College Hospital (P.J.H.), University of Toronto, Ontario, Canada
| | - Paula J. Harvey
- From the Cardiovascular Research Laboratory, Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada (E.O’D., J.M.G.); and Department of Medicine, Division of Cardiology, University Health Network at Mount Sinai Hospital (J.M.G., S.M., H.M., B.L.M, J.S.F.), and Department of Medicine, Division of Cardiology at the Women’s College Hospital (P.J.H.), University of Toronto, Ontario, Canada
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Freitas F, Estato V, Carvalho VF, Torres RC, Lessa MA, Tibiriçá E. Cardiac microvascular rarefaction in hyperthyroidism-induced left ventricle dysfunction. Microcirculation 2014; 20:590-8. [PMID: 23510303 DOI: 10.1111/micc.12057] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 03/15/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The pathophysiology underlying hyperthyroidism-induced left ventricle (LV) dysfunction and hypertrophy directly involves the heart and indirectly involves the neuroendocrine systems. The effects of hyperthyroidism on the microcirculation are still controversial in experimental models. We investigated the effects of hyperthyroidism on the cardiac function and microcirculation of an experimental rat model. METHODS Male Wistar rats (170-250 g) were divided into two groups: the euthyroid group (n = 10), which was treated with 0.9% saline solution, and the hyperthyroid group (n = 10), which was treated with l-thyroxine (600 μg/kg/day, i.p.) during 14 days. An echocardiographic study was performed to evaluate the alterations in cardiac function, structure and geometry. The structural capillary density and the expression of angiotensin II AT1 receptor in the LV were analyzed using histochemistry and immunohistochemistry, respectively. RESULTS Hyperthyroidism was found to induce profound cardiovascular alterations, such as systolic hypertension, tachycardia, LV dysfunction, cardiac hypertrophy, and myocardial fibrosis. This study demonstrates the existence of structural capillary rarefaction and the down-regulation of the cardiac angiotensin II AT1 receptor in the myocardium of hyperthyroid rats in comparison with euthyroid rats. CONCLUSIONS Microvascular rarefaction may be involved in the pathophysiology of hyperthyroidism-induced cardiovascular alterations.
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Affiliation(s)
- Felipe Freitas
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
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The thyroid and the kidney: a complex interplay in health and disease. Int J Artif Organs 2014; 37:1-12. [PMID: 24634329 DOI: 10.5301/ijao.5000300] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2013] [Indexed: 11/20/2022]
Abstract
Thyroid hormones may directly affect the kidney and altered kidney function may also contribute to thyroid disorders. The renal manifestations of thyroid disorders are based on hemodynamic alterations or/and to direct effects of thyroid hormones. The renin-angiotensin system plays a crucial role in the cross-talk between the thyroid and the kidney. Hypothyroidism may be accompanied by an increase of serum creatinine and reduction of glomerular filtration rate (GFR), whereas hyperthyroidism may increase GFR. Treatment of thyroid disorders may lead to normalization of GFR. Primary and subclinical hypothyroidism and low triiodothyronine (T3) syndrome are common features in patients with chronic kidney disease (CKD). In addition low levels of thyroid hormones may predict a higher risk of cardiovascular and overall mortality in patients with end-stage renal disease. The causal nature of this correlation remains uncertain. In this review, special emphasis is given to the thyroid pathophysiology, its impact on kidney function and CKD and the interpretation of laboratorial findings of thyroid dysfunction in CKD.
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Sarati LI, Toblli JE, Martinez CR, Uceda A, Feldman M, Balaszczuk AM, Fellet AL. Nitric oxide and AQP2 in hypothyroid rats: a link between aging and water homeostasis. Metabolism 2013; 62:1287-95. [PMID: 23706747 DOI: 10.1016/j.metabol.2013.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 03/28/2013] [Accepted: 04/20/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Hypothyroid state and aging are associated with impairment in water reabsorption and changes in aquaporin water channel type 2 (AQP2). Nitric oxide (NO) is involved in AQP2 trafficking to the apical plasma membrane in medullary collecting duct cells. The purpose of this study was to investigate whether aging and hypothyroidism alter renal function, and whether medullary NO and AQP2 are implicated in maintaining water homeostasis. MATERIALS/METHODS Sprague-Dawley rats aged 2 and 18months old were treated with 0.02% methimazole (w/v) during 28days. Renal function was examined and NO synthase (NOS) activity ([(14)C (U)]-L-arginine to [(14)C (U)]-L-citrulline assays), NOS, caveolin-1 and -3 and AQP2 protein levels were determined in medullary tissue (Western blot). Plasma membrane fraction and intracellular vesicle fraction of AQP2 were evaluated by Western blot and immunohistochemistry. RESULTS A divergent response was observed in hypothyroid rats: while young rats exhibited polyuria with decreased medullary NOS activity, adult rats exhibited a decrease in urine output with increased NOS activity. AQP2 was increased with hypothyroidism, but while young rats exhibited increased AQP2 in plasma membrane, adult rats did so in the cytosolic site. CONCLUSIONS Hypothyroidism contributes in a differential way to aging-induced changes in renal function, and medullary NO and AQP2 would be implicated in maintaining water homeostasis.
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Affiliation(s)
- Lorena I Sarati
- Department of Physiology, School of Pharmacy and Biochemistry, Universidad de Buenos Aires, IQUIMEFA-CONICET, Buenos Aires, Argentina.
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